Key result
Exercise and adenosine triphosphate stress tests showed no significant differences in inducing changes in left ventricular mechanical dyssynchrony parameters, including phase standard deviation (median 0.25 vs 0.42, P=0.73).
Why the study?
Left ventricular mechanical dyssynchrony can be induced after a stress test, but no studies have compared the influence of different stress-inducing methods on dyssynchrony parameters.
Does treadmill exercise stress testing compared to ATP stress testing cause different changes in left ventricular mechanical dyssynchrony parameters in patients with suspected or diagnosed CAD?
Observational (n=190)
No
Does treadmill exercise stress testing compared to ATP stress testing cause different changes in left ventricular mechanical dyssynchrony parameters in patients with suspected or diagnosed CAD?
Absolute Event Rate: 0.25% vs 0.42%
p-value: p=0.73
Exercise and ATP stress tests induce similar changes in left ventricular mechanical dyssynchrony parameters on GSPECT MPI, suggesting the two methods can be used interchangeably for this assessment.
No difference supports interchangeable use of exercise or ATP for post-stress LVMD assessment; leaves open generalizability and outcome impact.
BACKGROUND: Left ventricular mechanical dyssynchrony (LVMD) can be induced after stress test. However, no studies have compared the influence of different stress‑inducing methods on LVMD parameters. AIMS: The aim of the study was to determine whether there is a difference between exercise and adenosine triphosphate (ATP) stress tests in terms of changes in LVMD parameters assessed using gated single‑photon emission computed tomography myocardial perfusion imaging (GSPECT MPI). METHODS: A total of190 patients who underwent 99mTc ‑sestamibi GSPECT MPI were consecutively enrolled. Treadmill exercise and ATP stress tests were performed in 95 patients each. Normal myocardial perfusion was defined as the summed stress score (SSS) ≤3 and summed rest score (SRS) ≤3, myocardial ischemia as SSS >3 and SRS ≤3, and myocardial infarction as SSS >3 and SRS >3. Parameters of LVMD, including phase standard deviation (PSD), phase bandwidth (PBW), skewness, and kurtosis were compared. Subtraction was made between values during stress and rest phases to acquire ∆PSD, ∆PBW, ∆skewness, and ∆kurtosis Results: There were no differences in LVMD parameters between the exercise and ATP groups. The same results were obtained in the normal perfusion, ischemia, and infarction subgroups. Furthermore, no differences were observed in ∆PSD (median [interquartile range, IQR], 0.25 [-2.3 to 3.1] vs 0.42 (-1.7 to 3.1]; P = 0.73), ∆PBW (median [IQR], 1 [-7 to 11] vs 1 [-6 to 11]; P = 0.95), ∆skewness (mean [SD], -0.06 [0.63] vs 0 [0.81]; P = 0.53), and ∆kurtosis (median [IQR], -0.47 [-4.2 to 4.3] vs -0.42 [-4.8 to 5.2]; P = 0.73) between the exercise and ATP stress‑inducing methods. CONCLUSIONS: There are no differences between the exercise and ATP stress tests in terms of changes in LVMD parameters. Thus, the 2 methods can be used alternatively.
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Shi et al. (2021) conducted an observational in Coronary artery disease (n=190). Exercise stress test vs. Adenosine triphosphate (ATP) stress test was evaluated on Change in phase standard deviation (ΔPSD) (p=0.73). Exercise and adenosine triphosphate stress tests showed no significant differences in inducing changes in left ventricular mechanical dyssynchrony parameters, including phase standard deviation (median 0.25 vs 0.42, P=0.73).
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